The Contracting and Credentialing Process for New Dentists

Posted by Jordan Nickerson on Tuesday, July 9, 2019

It’s a busy time for recent dental graduates across the state. After years of planning and preparation, you have walked across the stage and have taken the first step of your professional career. However, while exciting, this time can certainly be filled with unfamiliarity as well.

Our Health Law team assists many new dentists as they transition from student to professional. When joining a practice, there are many important factors that you will want to consider at the outset to minimize patient and operational interruptions later on. One such consideration is the contracting and credentialing process.

Many recent graduates may overlook the fact that prior to patient interaction, they will likely be required to individually contract and credential as a participating dentist with insurance carriers accepted by their practice. Generally, this will include a review of the terms and conditions of the carrier’s participating dentist agreement and completion of a credentialing application. Often, the latter will be extensive and require substantial information including, but not limited to, the following:

  • Biographic information;
  • Licensure information;
  • Certification requirements;
  • Dental practice/ office information;
  • Malpractice coverage information; and
  • Specialty verifications.

This process is tedious and detailed. So, how can you avoid common mistakes in your paperwork? Starting early is critical. Provider relations departments are often inundated with applications, so it’s important to timely submit all documents. Further, it may be necessary to follow up on the status of your application once submitted. If additional information is needed, it should be provided sooner rather than later. Finally, if questions arise, consult an experienced credentialing professional or health law attorney that can assist in making this transition as efficient and as seamless as possible.

If you have any questions, please feel free to contact Jordan Nickerson or any member of our BrownWinick Health Law team.